A visit to the gynecologist is not only an essential part of your health routine. This is an opportunity for anyone with a cervix, vagina or ovaries to ask questions about their reproductive health, from painful periods to low libido.
If talking to your provider about this stuff makes you shy or squeamish, you’re not alone, says Dr. Rachel Bervell. She is a physician with training in obstetrics and gynecology and co-founder of the Black OBGYN Project.
“I come from a strict immigrant household,” she says. “I never got the birds and the bees talking. I never had those kinds of conversations.”
Today, Bervell is much more outspoken on this topic — in fact, there’s a viral video on Instagram of her talking about what happens during a Pap test…at her family’s Thanksgiving dinner.
You shouldn’t be afraid to speak up, either, especially when your health is at stake, says Bervell. To give you an idea of the types of questions you can ask your provider, Bervell answers questions from our listeners. Whether you are a woman, trans or non-binary, this story is for you. This interview has been edited for length and clarity.
I have terrible anxiety about Pap tests. Are there any changes I can make during a routine exam that gynecologists would be willing to consider?
Sometimes anxiety is due to a bad experience, whether conditions such as vaginismus (an involuntary tightening of the vagina) or other pain, or a previous (sexual) assault.
There are things you can do to make the Pap test easier. Consider your provider a partner in your care. If you feel there will be an issue with pain or discomfort, ask the provider to use a smaller speculum. Ask them to use more lube. And (ask them to help you) understand why you are taking this exam. Ultimately, it’s to prevent cancer. But it can be done in a way that prioritizes your needs and comfort.
I have intense period pain. How do I know if my pain is not normal?
Excessive pain during or outside of your cycle can be notable because it may indicate an underlying health problem: something is not “quite right” and is contributing to the resulting pain/discomfort. In this case, it is important to consult a doctor to identify the source of this problem, diagnose the underlying cause and receive treatment. The last thing we want to do is wait for the situation to get worse or for complications.
Conditions such as endometriosis, when menstrual tissue that is supposed to be in the uterus ends up outside the uterus, can cause debilitating pain and discomfort for patients.
If you experience severe period pain and are unable to get relief with an over-the-counter medication like Tylenol or ibuprofen, consider talking to your doctor or health care professional about other ways to relieve this pain. pain.
I am a postmenopausal woman who has had both ovaries removed and am not taking any hormone replacement therapy. How do I regain my libido?
When we stop our ovarian function, which is actually what menopause is all about, you no longer release eggs. You can no longer fertilize these eggs. And there will be a decrease in estrogen. Estrogen is necessary to maintain lubrication, elasticity and blood flow in the vagina. When estrogen decreases, vaginal dryness occurs.
I recommend an open and honest conversation with your healthcare professional. They may suggest hormone replacement therapy, vaginal estrogen, lubricants and moisturizers, or medications to treat sexual dysfunction. They can make sure you maintain positive health habits and comprehensively assess stress and psychological factors. Enjoying sex and having a libido is not only biological, it is also a lifestyle and behavior.
I have multiple sclerosis, which causes severe spasticity. For me to have a simple gynecological exam, two people have to support my knees and hold them open. But most doctors’ offices said they couldn’t accommodate me. As a result, I don’t see a gynecologist as often as I should, simply because it’s uncomfortable and embarrassing when my foot kicks at the doctor without my control. What should you do if you are having trouble finding a gynecologist who can meet your needs?
This is not the best answer, because it signals to the patient that they have to do the work themselves. But number 1 is you know what you need. And you know that providers are supposed to meet your needs as a patient with a disability.
Ensuring that the clinic is accessible to you should be your priority, and the clinic should be able to respect this and respond accordingly, because it is our duty. So talk about it, send a message in advance.
If your provider cannot accommodate you, find someone else who will respect how you come to the provider and ensure you receive the care you need.
How should I talk to a gynecologist about birth control?
The first question is to determine what your goals are. Is it because you don’t want to get pregnant and aren’t ready to start a family yet? Are you worried that your periods are not regular and you want some consistency? Or is it to relieve other health problems like acne or heavy bleeding (during your period)?
Once you understand this, your provider can talk you through all the options. One of the organizations I always refer to is Bededr.org. They did an amazing job of listing all the types of birth control with their effectiveness and what they do, what’s included, what they look like, where they go.
The digital story was edited by Margaret Cirino and Meghan Keane. The visual editor is Beck Harlan. We would like to hear from you. Leave us a voicemail at 202-216-9823 or email us at LifeKit@npr.org.
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